Tools to Navigate the 2023-24 Cold, Flu, and COVID Season

It feels both trite and necessary to write a “how to avoid getting sick this winter” post, so please bear with me while I share these five ways to reduce infection and get through our 2023-24 Cold, Flu, and COVID season. I think I’ve found some helpful tools you may not have heard about yet and I myself found the reminders around best practices to reduce the spread of virus illness helpful. I promise that more riveting and novel topics will be coming up next.

1. Avoid pathogen (virus, bacteria etc.) exposure:

Distancing: Try to avoid places and group gatherings where you might get sick. This can be impossible, especially for teachers, when little kids are in the mix, and holiday event obligations feel ever present. Normalizing not going to events and work sick would do a world of good in infectious disease but alas this is not as normalized as common sense might imply it should be.

Data: Being aware of local rates of virus and pathogen can help. One way to stay informed is to check local wastewater virus levels through your local Health Department or a site like WastewaterSCAN which tracks 12 pathogens or the National Wastewater Surveillance System (NWSS). Wastewater is a leading indicator of virus infection levels in local areas. Samples of waste water are sequenced for various pathogens and can provide an indicator as to which direction infection levels are trending. People can begin shedding virus in their stool, sometimes even before they feel sick. If levels are rising in your area, it might be time to reconsider events where you are in close contact with many people.

2. Blocking/minimizing pathogen exposure:

SARS-CoV-2 is a highly contagious respiratory virus so anything done to minimize chances of infection will reduce infection with other viruses and bacteria. Reducing exposure can help you out and about and if you are at home with a sick loved one and you would like to reduce your chances of getting sick.

The overall amount of pathogen you might be exposed too may change your course of disease. Being exposed to a high amount of virus all at once can overwhelm your immune system and even if vaccinated may cause breakthrough infection and a significantly worse course of disease.

Ways to reduce exposure to viruses when out and about:

Hand hygiene: wash your hands and use hand sanitizer when soap and water are not available. This is especially important before eating.

Wear a mask: A high quality N95, KN95, or KF94 that fits your face well will minimize pathogen exposure. Make sure it is crimped down over your nose and don’t take it off in high traffic areas (airport terminals etc.). Bonafide Masks provides an authenticity guarantee. Also make sure to look for a NIOSH mark, though counterfeit masks are being produced with NIOSH marks. Here is more information on how to tell if your mask is legitimate.

Ventilation: Areas with good ventilation, HEPA filters, and high ceilings where people are not closely packed together can minimize your chance of virus exposure.

Hot foods: Viruses don’t survive heat well. Avoid cold foods (salads etc.) unless prepared at home. Make sure to wash your fruits and vegetables well before eating.

3. Keeping your body otherwise healthy

Exercise:

Moderate to light exercise is known to improve immune system function, mood and general mental health among other things. This can look like a 20 to 30 minute daily walk or some active stretching and yoga. Doing more is great but consistently moving a little bit every day can add up to significant health benefits. (Note: links are to scientific consensus representative references and articles on a much larger research topic).

General Nutrition:

The supplement industry is a multi-billion dollar industry that is not well regulated both in terms of accuracy around statements of efficacy and the contents of the supplements. Because the industry is so massive and so poorly regulated there is quiet a bit of pseudoscience around selling the next big thing.

The majority of necessary nutrients can be obtained from eating a healthy diet containing fruits and vegetables. However, I would be remiss if I did not mention that many people tested, especially in the winter, have low vitamin D levels can impact physiologic and immune system function but having too much is not likely to change outcomes. Taking vitamin D will not prevent viral infection. However, if you have low vitamin D levels (a test your primary health care provider can run) it may be a good idea to take a physician recommended supplement. I personally have added iron by multivitamin and vitamin B12 supplementation to my diet as I’ve caught myself slipping into anemia at various times in my life. Once my hemoglobin was too low to donate blood - oddly I felt fine - which can be the case for many. Anemia can be common in menstruating people (est. 29% world wide) and is a good topic to bring up with your primary care provider to discuss further.

4. Making sure your immune system has all available tools to respond to a pathogen

Vaccination is a training session for your immune system. Our immune systems build memory after being exposed to a pathogen. Vaccination is a way to safely show a recognizable piece of a pathogen to your immune system. It can be thought of as a “Wanted Poster” that your immune system studies so it’s ready to respond the next time it sees the pathogen.

Immune system memory allows for a rapid response when you encounter pathogen. This rapid response can neutralize a pathogen before it can gain a foothold in your body and cause disease.

Vaccines are available in the United States this winter (2023-24) for Influenza and SARS-CoV-2 and the vaccines are a relatively good match for the variants that are in circulation. Vaccination for RSV is available for some groups (over 65 and pregnant people).

As anti-vaccine movements have gained traction in some areas of the United States it may be prudent to update MMR or Tdap vaccines if you have not been boosted for 10 or more years. The US CDC recommends a Tdap or Td shot every ten years. Please discuss this your health care provider.

5. Taking good care of yourself and others if you do get sick

If you are sick please consider taking one or more a rapid antigen tests for COVID (currently more free tests can be ordered at covidtest.gov). If you do have COVID contact your health care provider to see if Paxlovid or Molnupiravir (Lagevrio) is right for you. These medications can significantly lessen the severity and duration of infection. Please wear a mask and social distance from others as much as possible.

If you are sick but do not have COVID please do consider social distancing as much as possible and wearing a mask when not possible to reduce the spread of infectious disease to others who may be vulnerable or have vulnerable loved ones.

Although we are still early in the year I am anticipating a more mild cold, flu, and COVID season relative to last year. This, however, remains to be seen. Vaccination, mask wearing, social distancing, and hand washing reduce the spread of virus and small shifts in behavior by everyone can help reduce the overall morbidity and mortality burden of any given Cold, Flu, and COVID season.